TREOSULFAN AS REINDUCTION CHEMOTHERAPY IN SMALL-CELL LUNG-CANCER

Background: Although small-cell lung cancer (SCLC) is a primarily high ly chemosensitive malignancy, the majority of patients will ultimately relapse. As part of an ongoing effort to identify active new agents, the efficacy of treosulfan in patients with relapsed SCLC was examined in a monoinstitutional, phase II trial. Material and Methods: Between January 1995 and September 1996, 15 previously treated patients (limi ted; disease n = 1, extensive disease n = 14) with refractory (n = 1) or relapsed (n = 14) SCLC were included in this prospective phase II s tudy. The patients received treosulfan 8 g/m(2) intravenously as a sho rt infusion every 4 weeks. The application was terminated in case of d isease progression. Results: 14 patients are evaluable for response an d toxicity after receiving 1-6 courses of treosulfan. No complete or p artial remissions were seen. Three patients achieved a stable disease lasting 2, 3 and 10 months, respectively. Eleven patients showed disea se progression. The most common toxicities were thrombocytopenia (14% WHO grade 3-4) and leukocytopenia (5% WHO grade 3). Nonhematological t oxicities, e.g. alopecia, nausea, vomiting, stomatitis and skin reacti ons, were moderate and mild. Conclusions: No major efficacy was seen u sing treosulfan as second-line therapy in patients with extensive dise ase SCLC. There are no sufficient data, however, on the effectiveness of treosulfan in front-line therapy.